Tuesday, October 4, 2016

Fostering Herd Immunity

I read the words, but I couldn't believe them. I read them again, and was still stunned:

"Fostering herd immunity is essential on your part my friend."

This was in response to a sarcastic comment I posted on Twitter:



"Thank you, flu shot patron, for coming in on Monday morning at the most chaotic time possible. We LOVE the extra challenge that presents."

Any pharmacist will tell you that MONDAY morning is absolutely the WORST time to go to a pharmacy and ask for a flu shot. If you're a pharmacist, you know why. If not, take a look HERE.

There's a great way to illustrate this: Suppose you work in a chocolate factory and the Halloween orders start coming in. A good factory will hire more workers to handle the extra workload. But suppose they don't. Imagine it like this:



In a regular pharmacy we already have the extra workload that happens on Monday. Then when you add in all the extra disruptive factors associated with flu shots, it gets NUTS.

"Fostering herd immunity is essential on your part my friend."

This one sentence is so completely annoying it's unbelievable! And it was said by a physician's assistant ~ someone you would think should know better.

So if a patient goes to a physician's office and wants a flu shot... what will they be told? Make an appointment and come back. Or wait over there next to the sick people for a good hour. Then we'll call your name and put you in a room where you can wait another half hour. 

How long do you think that would last at Goofmart? Or any retail pharmacy? Ha! This is what happened one day when I was busy and asked a flu shot patron to wait a few damn minutes: LINK

When Goofmart Pharmacy first started offering flu shots to the public, our pharmacists asked how we would keep up with the extra workload. The same is true for offsite flu shot clinics, Medication Therapy Management, and Comprehensive Medication Reviews.


"You will be provided extra technician help," we were told.

It didn't happen. It hasn't happened. It will never happen.

I don't know of a single pharmacy in my Tri-County area that has extra tech help to handle flu shots, offsite flu shot clinics, MTMs, or CMRs.

Flu shots have increased the script count, which in turn should have increased the number of technician hours. At first we were told, "Sorry, we don't have anyone to send you." Now we're told that the labor model has changed. It's not about script count anymore. It's about sales and profit. The number of technician hours is based on your sales/profit level. And since reimbursements are down, golly darn it, we can't send you more tech help because you don't qualify, despite the fact your physical workload has increased 25% over the last 18 months.

Oh, but what was I thinking? It's not about profit. It's about healthcare and herd immunity! Don't you understand you have a duty to the public, RxMan?

Ah, that illusion of extra tech help, and the contradiction. First they tell you that it's not about profit ~ it's about protecting the public, then they tell you you can't have more technician help because of less profit even when having extra technician help protects the public!

But what they don't want to discuss is the big problem with the extra workload of pharmacists giving flu shots without extra technician help:



It's a simple graph. As the number of prescriptions increases per pharmacy shift, the likelihood of pharmacist error increases. As pharmacist errors increases, the likelihood that one of those errors will be serious and/or life-threatening increases.

That's a fact... and it's not linear. It's exponential. As you increase the number of scripts in the same time period, the probability of error increases exponentially. Now here's the real kicker: Upper management is aware of this but they trade the possibility of error for the added profit (by not hiring extra help).


In other words, someone who has never worked in a pharmacy crunched the numbers and decided that patient safety is a risk... a gamble worth taking. We'll throw the dice and hope we never get snake eyes. Patient safety isn't as important as profit. This... all the while telling us that we're doing flu shots to provide healthcare, herd immunity, and protect the public.

That's not "herd immunity," my friend. That's pure EVIL.

1 comment:

Anonymous said...

They gamble and when an error occurs they will throw you, the pharmacist, under the bus and hire someone else. Then the cycle starts all over again